Investigating rabies is a whole different story; sometimes involving several different agencies depending upon what types of animals are involved (wild or domestic); several quarantine guidelines depending on what a suspected rabid animal came in contact with (human or another animal); and several outcomes for animals depending on their vaccination status (current or not current).

It's understandable that misinformation gets relayed, especially considering the recent rapid increase in rabies we've seen in northeast Colorado since January, and the number of agencies that have a vested interest in halting its progress. However, as the primary agency that enforces the state regulations for rabies control in regards to domestic animals, we'd like to take a moment to clear up a few topics.

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Rabies Vaccine: The most efficient rabies vaccine is the one for your pet, and it can sometimes run as low as $15 or less. A vaccinated pet creates a barrier between you and any possible rabid animals they may come in contact with. The key here is that the vaccination must be given by a licensed veterinarian to be recognized. Although you can purchase rabies vaccine at a number of locations and vaccinate your pet on your own, it is not considered valid under state statute. This is because there is no way to ensure the vaccine was stored appropriately or given correctly. There is a vaccine for humans, but because of expense, limited supply, and limited need in the general public, it is targeted to people in high-risk groups such as veterinarians and laboratory workers. It would be highly unlikely if any human, outside that high risk group, has ever received a rabies vaccine. It is actually more cost-effective to treat with post-exposure treatment rather than a human vaccine in the U.S.

Post-exposure prophylaxis (also known as PEP): PEP is available for humans only. There is no post-exposure treatment for animals. There are rabies booster shots for animals that have previously been vaccinated and are exposed, but that is something entirely different. PEP is a series of five shots that humans receive after they've been exposed to a rabid, or suspected rabid, animal. Depending on your insurance, PEP can be very expensive, sometimes running several thousand dollars or more. The cost for PEP, much like any other medical procedure, is borne by the person needing treatment, but sometimes there are special programs that can help with the cost if insurance does not. Choosing to forego PEP (yes, this is a personal choice, we cannot make you take it) if you've been exposed to rabies is not a good idea as once symptoms start, death is usually imminent.

Quarantine periods: This is one of the most misunderstood and heart rending elements of rabies control; how long animals are placed in quarantine and/or when euthanasia is recommended over quarantine. Quarantine or euthanasia is determined by two things; (1) whether it was an animal or human that got bit, and (2) if it was an animal that got bit, the status of their vaccination history.

•10-day quarantine: Animals are only placed in 10-day quarantine when it is a human they have bitten. The 10 days is a symptom watch for the animal that did the biting. Rabies can only be transmitted when the disease has developed in the animal, which is usually evident with rabies symptoms. Any animal showing rabies symptoms would be dead within 10 days and therefore have the ability to transmit the disease. Therefore, the 10-day quarantine period is sufficient to determine the presence of disease and the subsequent need for PEP. A fully-vaccinated pet can serve that quarantine period at home, while an unvaccinated pet will have to serve that quarantine period in a secure facility approved by NCHD and monitored by a licensed veterinarian at the owners' expense. If a pet owner cannot afford the expense, it is recommended the animal be euthanized.

•45-day quarantine: This is the best-case scenario when an animal is bitten by another animal, either confirmed or suspected of rabies. This quarantine is served at home and is an option when the animal that got bit is current with their rabies vaccination status.

•180-day quarantine/Euthanasia: This is the worst-case scenario when an animal is bitten by another animal, either confirmed or suspected of rabies, and the animal is not current with their rabies vaccination status. According to state statute the preferred recommendation in these types of cases is actually euthanasia. This is mainly due to the possible continued exposure to people and the expense of a 180-day quarantine, the first 90 days of which must be served in a secure facility approved by NCHD and monitored by a licensed veterinarian at the owners' expense. Average boarding expenses can run over $1,000 for the 90-day containment, per pet. Typically it is NCHD that will work with a pet owner to determine which method is feasible in these circumstances.

Sampling: The Journal-Advocate recently ran an article saying that since we know rabies is in this area we don't need samples anymore; that's only partially true. While we don't need to go out and collect every dead skunk anymore, we need access to suspected rabid animals if there has been an interaction with an animal or human. In this case, without an animal sample to submit for laboratory confirmation of rabies, we have to go with the worst case scenario and assume a rabies exposure. If the animal is available for testing, this provides NCHD and the family with the necessary information to effectively determine with certainty the need for PEP (for the human) and/or euthanasia or quarantine (for the animal).

Deanna Herbert is the Public Information Officer at the Northeast Colorado Health Department

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